There are plenty of imponderables left on the fate of the ACA, Obama’s signature domestic policy achievement. Premiums could still spike later this year; the full data on the numbers with actual, paid-for health insurance via the exchanges is not yet known; the resistance on the right to it is still mighty; in many states, the lack of Medicaid expansion guts a key part of the law’s intent. If you want to read an attempt to argue that Obamacare is as big a liability for Obama this fall as the Iraq War was for Bush in 2006, well go read JPod. My reaction after reading his screed was: seriously?
There’s simply no denying that the law has been rescued by an impressive post-fiasco operation that did to ACA-opponents what the Obama campaign did to the Clintons in 2008 and to Romney in 2012. Obama out-muscled the nay-sayers on the ground. I have a feeling that this has yet to fully sink in with the public, and when it does, the politics of this might change. (Since the law was pummeled at the get-go as something beyond the skills of the federal government to implement, its subsequent successful implementation would seem to me to do a lot to reverse the damage.) There are some signs that this is happening. A new Reuters/Ipsos poll finds the following:
Nearly one-third of respondents in the online survey released on Tuesday said they prefer Democrats’ plan, policy or approach to healthcare, compared to just 18 percent for Republicans. This marks both an uptick in support for Democrats and a slide for Republicans since a similar poll in February.
That’s mainly because of renewed confidence and support from previously demoralized Democrats. But it’s also a reflection, it seems to me, of the political vulnerability of Republicans who have failed to present a viable alternative to the law, and indeed seem set, in the eyes of most voters, merely to repeal ACA provisions that are individually popular. And this bad position is very likely to endure because of the intensity of the loathing for Obama/Obamacare among the Medicare recipients in the GOP base. It seems to me that right now, the GOP cannot offer an alternative that keeps the more popular parts of Obamacare without the air fast leaking out of their mid-term election balloon. And so by the fall, the political dynamics of this may shift some more in Obama’s direction. By 2016, that could be even more dramatic. One party – the GOP – will be offering unnerving change back to the status quo ante, and the other will be proposing incremental reform of the ACA. The only thing more likely to propel Hillary Clinton’s candidacy would be a Republican House and Senate next January.
It’s that long game thing again, isn’t it? Like the civil rights revolution of the Obama years, it seemed a close-to-impossible effort to start with, and then was gradually, skillfully ground out. It also seems true to me that the non-event of the ACA for many, many people will likely undermine some of the hysteria on the right. The ACA-opponents may be in danger of seeming to cry wolf over something that isn’t that big a deal. Yes, they may have premium hikes to tout as evidence of the alleged disaster. And every single piece of bad news on the healthcare front will be attributed to the ACA, fairly or not. But the public will still want to know how premiums can go down without people with pre-existing conditions being kicked out of the system, or without kids being kicked off their parents’ plan, and so on. I think, in other words, that the GOP’s position made a lot of short-term political sense in 2010 and even 2012. But it’s a much tougher sell in 2014, let alone 2016. Once again, they have substituted tactics for strategy. Every time they have done that with Obama, they have failed.
Or maybe I’m biased because my own insurance situation has gotten better. Here’s what’s happened in my individual case.
I stayed on my Newsweek plan via COBRA for my first year as a new business-owner. But when I went on the exchanges this year before my COBRA ran out, I was pleasantly surprised. My old plan had a premium for me and my hubby of $1,535.59 per month, with an in-network out-of-pocket maximum of $2,500 per person. So in 2013 I had total out-of-pocket costs (premiums plus my out-of-pocket maximum of $2,500) of $20,927.08. This year, my ACA plan – a Platinum DC-based one – has a monthly premium of $1,106.33 for the two of us, with an in-network out-of-pocket maximum of $1,800 per person. My out of pocket medical costs this year will therefore be $15,075.96. (One small note: my previous plan was slated for a reduction in premiums this year as well. Not by as much as my current plan – but a significant one nonetheless. But since my COBRA option ran out this June, it wasn’t really a choice.)
So I’m a lot better off with Obamacare this year. I’m also buoyed by the fact that DC’s exchanges have a high number of the young and healthy in them – balancing out my aging AIDSy ass. So I’m reasonably confident my plan won’t go down the toilet any time soon, or face big hikes in premiums. And this new insurance means a lot more to me than the old one – because it cannot be taken away, even if the Dish goes belly-up. When you are a long-term HIV survivor, that kind of health security and independence is, well, priceless. Obamacare affected me in another critical way as well. Its assurance of a stable insurance market that does not screen out someone with a pre-existing condition made me far more comfortable starting my own business. It gave me a baseline of security that simply didn’t exist before. It helped make entrepreneurialism possible.
Yes, I am just one tiny, and rare example. But for me, at least, Obamacare has over-delivered and over-performed. If my experience is replicated more widely, then I suspect the polling and politics will shift yet again.
Meep motherfucking meep.
(Photo: Dennis Brack/Black Star/Getty Images)